Effect of hyoid suspension with uvulopalatopharyngoplasty in the treatment of obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To discuss the methodology and therapeutic effect of hyoid suspension in association with uvulopalatopharyngoplasty (UPPP) in the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS).</p><p><b>METHODS</b>Sixty-nine patients with severe OSAHS (apnea hyponea index, AHI > 30) were treated with hyoid suspension and UPPP. Sixty-one patients were followed for 6 months (48 of them for 12 months). Polysomnogram (PSG) tests were performed and an Epworth sleepiness scale (ESS) was recorded preoperatively and postoperatively in these patients.</p><p><b>RESULTS</b>After the surgery,the snoring of the patients disappeared or was alleviated to varing degrees. Eighteen patients underwent fiberoptic nasopharyngolaryngoscopic examination. Twelve of them showed palatopharyngeal and glossopharyngeal stenosis was improved 6 months after surgery. Six patients showed no change, but had no glossoptosis. Fourteen patients underwent fiberoptic nasopharyngolaryngoscopic examination 1 year after surgery, with no recurrence of the stenosis being found. A decrease of 50% in the AHI was considered effective, and in patients the effective rate was 78.7% (48/61) 6 months after the operation and 75.0% (36/48) 1 year after the operation. The average AHI decreased from 44.8 to 15.1 and 17.2, and the minimum arterial oxygen saturation average increased from 0.512 to 0.880 and 0.730. Matching t tests were utilized and the results of follow-up indicated that there was a significant improvement in the indexes in those cases which could be followed up (P < 0.01). The average of the ESS was 6.7 six months after operation and 7.2 one year after operation, with a significant decrease compared to the preoperative (16.6) data (P < 0.01).</p><p><b>CONCLUSIONS</b>Modified hyoid suspension in association with UPPP has the advantage of a simple operation, short hospitalization and less expense, and the effect of the operation was significant. Patients with palatopharyngeal and glossopharyngeal stenosis should be chosen for this operation.</p>